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Body Art Inspection Report <br />County of San Joaquin County, Environmental Health Department <br />1868 E. Hazelton Ave., Stockton CA 95205 <br />(209) 468-3420 www.siaov.oro/ehd <br />Date (MM/DD/YY) <br />Permit Number f_ ( 'I <br />Permit Type <br />Facility Name Address City Zip Code CT <br />s , =rew rad q52-7,6-&1 <br />Permit/Registration Holder Name Permit Exp. Date Total Time Inspection Type <br />Received by (Print): Received by (Signature): Phone: <br />Specialist (Print): Specialist (Signature): Phone: <br />This report is an Official Notice of Violation. Corrections must be completed in the time specified. <br />A reinspection fee may be charged if violations noted on this report are not corrected by the reinspection date. <br />Pace of <br />Reinspection Date (on or about) <br />i <br />i <br />L 'i M FA 0 ffP, 7 1r': <br />��.��. -` <br />� �Jf r3� �iy .ISI I•" �L� �►'._ ��� <br />� <br />�.., r. <br />SO AMMAr" <br />r♦ ;LLQ[ <br />y f <br />+ <br />L '. .. VArm <br />_ -'I <br />+t/.L <br />.� <br />i •f � . s� SLI Li irJi>r .r _ <br />1!' yy i w ... ww �L <br />jj <br />atIll... <br />1 <br />♦ IL �.� t ._a C:- .:a% fl .,l 1,•. .._. <br />1t1 M11111 if.;_ <br />Received by (Print): Received by (Signature): Phone: <br />Specialist (Print): Specialist (Signature): Phone: <br />This report is an Official Notice of Violation. Corrections must be completed in the time specified. <br />A reinspection fee may be charged if violations noted on this report are not corrected by the reinspection date. <br />Pace of <br />Reinspection Date (on or about) <br />